Provider Demographics
NPI:1326074253
Name:RICHARDS, CHERYL A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:A
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PSYD
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Other - First Name:
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Mailing Address - Street 1:4511 FOREST PARK AVE
Mailing Address - Street 2:STE 4300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2138
Mailing Address - Country:US
Mailing Address - Phone:314-286-1700
Mailing Address - Fax:314-408-2756
Practice Address - Street 1:3015 N BALLAS RD
Practice Address - Street 2:STE 550D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2329
Practice Address - Country:US
Practice Address - Phone:314-286-1700
Practice Address - Fax:314-362-7017
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR0458103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO498657303Medicaid
MO000070875Medicaid